Expert team performs Exploratory Laparotomy to help patient with
thickened descending colon, sigmoid colon and upper rectum
A 37-year-old male visited Nanavati
Super Speciality Hospital, Mumbai
with the chief complaint of pain in the
left iliac fossa and passing of mucous
and blood in stool for the past one
year. He had visited other hospitals
for the same problem where repeated
Colonoscopies were done with no
conclusive diagnosis.
The patient was admitted and
started on IV fluids and antibiotics.
Routine investigation results were
all within normal limits. CEA levels
were also found to be within normal
limits. Clinically the patient was
hemodynamically stable. He had
tenderness in the left iliac fossa with
lumpy feel. Rectal examination
was performed which revealed
irregular mucosa about 4cm from the
anal verge.
CT scan of abdomen and pelvis
suggested of thickened descending
colon, sigmoid colon and upper
rectum. The patient was managed
conservatively and was discharged
with directions to take oral antibiotics.
However, the patient came back again
with similar complaints after 15 days.
Abdominal findings were the same as
before. As per the rectal examination,
previous irregularity of mucosa was
not felt.
The patient was posted for
Exploratory Laparotomy.
There was evidence of
thickened descending
colon, sigmoid and upper
rectum with tethered
mesenteric. Resection
of the involved segment
was done, and descending
colon was anastomosed to
lower rectum.
Post-operative period
was uneventful.
Histopathology reports
revealed ischemic
colitis. Follow up result
was also favourable,
and the patient is now
living a normal routine
life. Segmental colonic
ischemic stricture in a
young patient without
predisposing factors
or co-morbidities is a
rare entity. The patient
is being referred to a
haematologist to rule out
hypercoagulable state.
Dr. Amol Joshi
Sr. Consultant
General & Laparoscopic
Surgery
Nanavati Super
Speciality Hospital,
Mumbai